Cognitive Behavioral Therapy (CBT)

Externalizing
Information handouts
Facing Your Fears (CYP)
Exercises
Facing Your Fears And Phobias
Guides
Fact Or Opinion
Exercises
Fatigue Activity Diary
Worksheets
Fear Ladder
Worksheets
Flashbacks - Self-Monitoring Record
Worksheets
Fortune Telling
Information handouts
Friendly Formulation
Worksheets
Functional Analysis
Worksheets
Functional Analysis With Intervention Planning
Worksheets
Habituation
Information handouts
Health Anxiety - Self-Monitoring Record
Worksheets
Health Anxiety Formulation
Information handouts
Health Anxiety Self-Monitoring Record (Archived)
Archived
Health Anxiety Thought Record
Worksheets
Hindsight Bias
Information handouts
Hindsight Bias (Archived)
Archived
Hotspot Record
Worksheets
How Trauma Can Affect You (CYP)
Information handouts
Identifying The Meaning Of Body Sensations
Worksheets
Identifying Your Demanding Standards
Worksheets
Interoceptive Exposure
Exercises
Interpersonal Beliefs And Styles
Worksheets
Intolerance Of Uncertainty
Information handouts
Intrusion Record
Worksheets
Intrusive Memory Record
Worksheets
Intrusive Thoughts Images And Impulses
Exercises
Jumping To Conclusions
Information handouts
Labeling
Information handouts
Lapse And Relapse Management
Worksheets
Longitudinal Formulation 1
Worksheets
Longitudinal Formulation 2
Worksheets
Low Self-Esteem - Self-Monitoring Record
Worksheets
Low Self-Esteem Formulation
Worksheets
Magnification And Minimization
Information handouts
Managing Social Anxiety: Therapist Guide
Treatments That Work®
Managing Social Anxiety: Workbook
Treatments That Work®
Managing Substance Use Disorder: Practitioner Guide
Treatments That Work®
Managing Your Substance Use Disorder: Workbook
Treatments That Work®
Mastery And Pleasure Activity Diary
Worksheets
Mastery Of Your Anxiety And Panic: Therapist Guide
Treatments That Work®
Mastery Of Your Anxiety And Panic: Workbook
Treatments That Work®
Mastery Of Your Anxiety And Worry: Therapist Guide
Treatments That Work®
Mastery Of Your Anxiety And Worry: Workbook
Treatments That Work®
Maximizing The Effectiveness Of Exposure Therapy
Information handouts
Meaning In Tinnitus
Exercises
Mental Filter
Information handouts
Mind Reading
Information handouts
Modifying Rules And Assumptions
Worksheets
Negative Thoughts - Self-Monitoring Record
Worksheets
Nightmare Exposure And Rescripting
Exercises
Nightmare Rescripting (Audio)
Audio
OCD Diary
Worksheets
OCD Hierarchy
Exercises
Operant Conditioning
Information handouts
Overcoming Depression: Therapist Guide
Treatments That Work®
Overcoming Depression: Workbook
Treatments That Work®
Overcoming Eating Disorders: Therapist Guide
Treatments That Work®
Overcoming Insomnia: Therapist Guide
Treatments That Work®
Overcoming Insomnia: Workbook
Treatments That Work®
Overcoming Your Eating Disorder: Workbook
Treatments That Work®
Overgeneralization
Information handouts
Overview Of CBT
Information handouts
Pain Activity Diary
Worksheets
Panic - Self-Monitoring Record
Worksheets
Panic Attack Progress Record
Worksheets
Panic Attack Record
Worksheets
Panic Diary
Worksheets
Panic Formulation
Worksheets
Panic Symptom Tracker
Worksheets
Perfectionism Self-Monitoring Record
Worksheets
Permissive Thinking
Information handouts
Permissive Thinking – Self-Monitoring Record
Worksheets
Personalizing
Information handouts
Perspective-Taking
Worksheets
Pie Charts
Exercises
Play The Script Till The End
Exercises
Positive Belief Record
Worksheets
Problem Solving
Exercises
Problem Solving (CYP)
Exercises
Process Focused Case Formulation
Worksheets
Prolonged Exposure Therapy For PTSD: Therapist Guide
Treatments That Work®
Prompts For Challenging Negative Thinking
Exercises
PTSD And Memory
Information handouts
PTSD Formulation
Worksheets
Putting It All Together (Psychology Tools For Living Well)
Books & Chapters
Reciprocal CBT Formulation
Worksheets
Reclaiming Your Life From A Traumatic Experience: Workbook
Treatments That Work®
Rumination - Self-Monitoring Record
Worksheets
Rumination Diary (Archived)
Archived
Safety Behaviors
Information handouts
Safety Behaviors Example
Information handouts
Safety Plan
Exercises
Schema Bias
Information handouts
Schema Formulation
Worksheets
Schema Metaphors
Information handouts
Self Critical Thought Challenging Record
Worksheets
Self Practice Record
Worksheets
Self-Blame
Information handouts
Assessment
- Patient Health Questionnaire 9 (PHQ-9) download archived copy
- Montgomery & Asberg Depression Rating Scale (MADRS) download archived copy
- Brief Fear of Negative Evaluation Scale (Social Anxiety) download archived copy
- Bern Inventory of Treatment Goals download archived copy
Cognitive therapy competence / adherence measures
- Assessment of Core CBT Skills (ACCS) – Muse, McManus, Rakovshik, Kennerley
- Website accs-scale.co.uk
- Manual accs-scale.co.uk
- Feedback form accs-scale.co.uk
- Cognitive Therapy Rating Scale (CTRS) – Young & Beck
- Scale download archived copy
- Manual download
- Revised Cognitive Therapy Scale (CTS-R) – James, Blackburn, Reichelt
- Scale download archived copy
- Manual download archived copy
Case Conceptualization / Case Formulation
- The case formulation approach to cognitive behavior therapy | Jacqueline Persons | 2014 download archived copy
- A case formulation approach to cognitive-behavior therapy | Jacqueline Persons | 2015 download archived copy
- Case formulation in CBT | Caleb Lack download archived copy
- Developing a cognitive formulation | Michael Free download archived copy
- Dysfunctional assumptions ideas download archived copy
- CBT case formulation video | Jacqueline Persons youtube
Presentations
- Making CBT Work (Working with your CBT therapist / Making your CBT therapist work with you) | Paul Salkovskis
downloadarchived copy - The unified protocol for the transdiagnostic treatment of emotional disorders | Ellen Frank, Fiona Ritchey | 2015 download archived copy
- Transdiagnostic treatments for anxiety disorders | Martin Anthony | 2013 download archived copy
- A case formulation approach to cognitive-behavior therapy | Jacqueline Persons | 2015 download archived copy
- The role of a case conceptualization model and core tasks of intervention | Donald Miechenbaum | 2014 download archived copy
Recommended Reading
- Arch, J. J., & Craske, M. G. (2009). First-line treatment: a critical appraisal of cognitive behavioral therapy developments and alternatives. Psychiatric Clinics of North America, 32(3), 525-547
downloadarchived copy - Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cognitive therapy and research, 36(5), 427-440 download
- Padesky, C. A., Mooney, K. A. (1990). Clinical tip: presenting the cognitive model to clients. International Cognitive Therapy Newsletter, 6, 13-14 download archived copy
- A therapists’ guide to brief cognitive behavioral therapy by Cully & Teten download
This series of articles are good introduction to the basics of CBT. The authors have gone on to sell a branded form of CBT using some of these metaphors / explanation but the messages apply equally to generic CBT.
- Williams, C., & Garland, A. (2002). A cognitive–behavioural therapy assessment model for use in everyday clinical practice. Advances in Psychiatric Treatment, 8(3), 172-179. download
- Garland, A., Fox, R., & Williams, C. (2002). Overcoming reduced activity and avoidance: a Five Areas approach. Advances in Psychiatric Treatment, 8(6), 453-462. download
- Williams, C., & Garland, A. (2002). Identifying and challenging unhelpful thinking. Advances in Psychiatric Treatment, 8(5), 377-386. download
- Wright, B., Williams, C., & Garland, A. (2002). Using the Five Areas cognitive–behavioural therapy model with psychiatric patients. Advances in Psychiatric Treatment, 8(4), 307-315. download
What Is Cognitive Behavioral Therapy?
Assumptions of CBT
- people actively process information;
- our appraisals (the way that we think and interpret events) determine how we feel;
- dysfunctional thinking and biases in information processing (cognition/thinking) are responsible for the problems that people experience;
- different problems are associated with different cognitive themes (cognitive specificity theory): depression is associated with loss and defeat; anxiety is associated with danger and threat; obsessive-compulsive disorder is associated with inflated responsibility; substance abuse is associated with permissive beliefs; eating disorders are associated with self-criticism; social anxiety is associated with fear of evaluation; and PTSD is associated with appraisals of immediate threat;
- the thoughts that we have can be ‘distorted’ or biased. Common biases include over-generalization, arbitrary inference, selective abstraction, and catastrophizing;
- changing how we think and act will impact how we feel: cognition, emotion, and behavior interact in a reciprocal manner;
- psychopathology is a result of an interaction between stress and vulnerability;
- cognition happens at multiple levels (Alford & Beck, 1997) and all can influence the way that we feel and behave: preconscious, unintentional, automatic (e.g., negative automatic thoughts); the conscious level (e.g., if a patient is asked to explain the meaning of an automatic thought); and the metacognitive level (beliefs about beliefs);
- experiences, memories, thoughts, attitudes, and beliefs are encapsulated as ‘schemas’ and which may become activated and influence our perceptions and behaviors.
Principles of CBT
Judith Beck (1995) identified 11 principles of the practice of cognitive behavioral therapy, and these were expanded by Wills (2009):
- cognitive behavioral therapists use formulation to focus their therapeutic work
- cognitive behavioral therapists use formulation to tackle interpersonal and alliance issues
- cognitive behavioral therapy requires a sound therapeutic relationship
- cognitive behavioral therapists stress the importance of collaboration in the therapeutic relationship
- cognitive behavioral therapy is brief and time-limited
- cognitive behavioral therapy is structured and directional
- cognitive behavioral therapy is problem- and goal-oriented
- cognitive behavioral therapy initially emphasizes a focus on the present
- cognitive behavioral therapy uses an educational model
- homework and self-practice is a central feature of cognitive behavioral therapy (incorporating the use of CBT worksheets)
- cognitive behavioral therapists teach clients to evaluate and modify their thoughts
- cognitive behavioral therapy uses various methods to change cognitive content including thought records, behavioral experiments, surveys
- cognitive behavior therapy uses a variety of methods to promote behavioral change including exposure, behavioral experiments, role-play.
Procedures and Techniques of CBT
- Data gathering and symptom monitoring are used to understand problems and to measure change. CBT is an evidence-based approach that relies upon accurate data gathering regarding symptoms and experiences.
- Behavioral activation is a set of techniques for encouraging engagement in meaningful activity and is an effective treatment for depression.
- Case formulation is a method for understanding the origin and maintenance of a problem in cognitive and behavioral terms. CBT therapists may use a mixture of cross-sectional formulation to understand difficulties in the here-and-now, longitudinal formulation to understand the origins and precipitants of a problem, and cognitive behavioral models to understand the mechanisms underlying a problem.
- Cognitive restructuring describes techniques for changing what we think. It often involves the use of thought records, behavioral experiments, data gathering, or psychoeducation.
- Exposure is a technique from behavior therapy that is extensively used by CBT therapists, particularly for the treatment of anxiety. ‘Facing your fears’ is an essential behavioral component of CBT.
- Problem solving describes a series of techniques that are often taught as part of a CBT intervention. Effective problem solving helps people to make adaptive choices.
- Socratic methods are used by CBT therapists to help their clients explore what they know, and to form their own opinions on a topic. Aaron Beck encouraged the use of Socratic-like technique in his original treatment manual “use questioning rather than disputation and indoctrination … it is important to try to elicit from the patient what he is thinking rather than telling the patient what the therapist believes he is thinking” (Beck et al, 1979).
References
- Alford, B. A., & Beck, A. T. (1997). The relation of psychotherapy integration to the established systems of psychotherapy. Journal of psychotherapy integration, 7(4), 275-289.
- Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.
- Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford.
- Wills, F. (2009). Beck’s cognitive therapy. CBT Distinctive Features Series. New York: Routledge.